Whenever I notice veterinarians widely prescribing a new drug … I like to look at the history of that pharmaceutical.
History can always tell us a lot, as can the money trail.
I also look up the scientific research behind the drug. I read those double-blind placebo-controlled studies. The ones that Big Pharma and conventional veterinarians use to bully the alternative medicine community.
About 7 or 8 years ago I began hearing about a lot of dogs with arthritis and chronic pain. They were being given gabapentin and Tramadol instead of non-steroidal anti-inflammatories.
Many of the owners were calling me … because the dogs weren’t reacting well to the medications… and were still in considerable pain. An 80 lb Lab who can’t get up and walk is a problem. It can lead to life and death decisions.
What was this new drug called gabapentin? And why, all of a sudden, was it flooding the veterinary market?
Gabapentin’s Sordid History
Gabapentin was first developed in 1975. In 1993, the FDA approved it to treat epilepsy for humans… and in 2002, to treat postherpetic neuralgia (shingles).
It’s best known under Pfizer’s brand name, Neurontin. Neurontin became one of Pfizer’s best selling drugs.
But within a few years, Pfizer (then Warner-Lambert) was in litigation. They were illegally marketing the drug… for at least a dozen off-label uses that the FDA hadn’t approved.
Pfizer had violated federal racketeering law by improperly promoting the drug … with off-label prescriptions accounting for a whopping 90% of Neurontin sales.
Pfizer settled the off-label case in 2004. They paid criminal charges and civil liabilities totaling $430 million … one of the largest pharmaceutical settlements in history.
And then, in 2009, pregabalin, a gabapentin derivative called Lyrica … was part of a massive $2.3 billion dollar settlement against Pfizer.
Not only was the drug being used off-label … it was causing multiple concerns in the human medical field. Reports of side effects are many, including this list:
- Myoclonus (involuntary muscle jerking)
- Suicidal thoughts
- Withdrawal syndrome (confusion, agitation, upset stomach, delirium)
And it induced pancreatic cancer in rats through an unknown mechanism.
Veterinary Use Of Gabapentin
2008 was one of the earliest references I could find to gabapentin in the veterinary world. There was a short article on Veterinary Information Network (VIN), revised in 2017.
That’s right. Despite the 2004 and 2009 settlements against Pfizer … in 2008 the drug showed up in the veterinary world.
This is what the recent Plumbs veterinary pharmaceutical formulary had to say:
- Caution in renal failure or insufficiency
- Extra-label use in seizures; “evidence to support use is relatively weak”
- Extra-label use as adjunctive analgesic: “Evidence to support use strengthens in recent years … may be effective in some dogs, for chronic pain with a neuropathic component.”
Note the cautious language: “may be,” “some dogs,” “extra-label.” There’s not much confidence in its effectiveness.
Other veterinary articles … not research studies … stated some interesting tidbits:
- Gabapentin can cause deficiencies in calcium (it works on the calcium channels … not on the neurotransmitter GABA), vitamin D, vitamin B1, and folate. Ironically, all of these nutrients are needed for nerve repair.
- Most dogs develop tolerance over time … so they need higher doses – and the risk increases along with the dose, of course.
- Gabapentin is not FDA-approved … but vets still frequently prescribe it to manage pain.
There have been zero controlled research studies on gabapentin to treat chronic pain. Case reports indicate mixed results.
I found no double-blind placebo-controlled research studies in dogs. That means there’s no information to support its use in treating chronic pain. If you find one please forward it to me!
A 2018 review found that gabapentin … was of no benefit in sciatica or low back pain in humans.
Another study in 2009 found gabapentin influences a receptor that helps create new synapses in the brain. Gabapentin can block a specific receptor that’s responsible for making new neuronal connections for growing, developing and repairing the brain.
This means that gabapentin can actually inhibit new neural connections from forming.
My Observations About Gabapentin
What have I observed about gabapentin’s side effects in private practice?
First of all, I have never prescribed it myself, nor would I. The dogs I see on gabapentin come to me already taking it. I find other options so we can discontinue gabapentin quickly.
I’ve seen patients become lethargic, develop vomiting and diarrhea, and tremors. These symptoms all went away when we discontinued the drug.
Two elderly patients developed signs of cognitive disorder, head pressing, getting stuck in corners, staring into space. Both of them recovered after discontinuing the drug.
And I’m not alone.
Rita Hogan, a canine herbalist, shared with me her experiences of several problems in dogs. She reported dogs becoming more aggressive, exhibiting signs of dementia and memory loss.
Rita also witnessed a family member developing signs of senility, memory loss, and confusion with this drug.
I haven’t seen a case where gabapentin really made a difference in pain management.
When I discontinue the drug, I add in acupuncture, herbal medicine, and hemp oil for pain management.
All these are much safer and more effective alternatives to gabapentin. A drug that has NO scientific evidence or FDA approval to back it up.
So why exactly is the veterinary community prescribing this drug?
- It’s caused deleterious side effects in humans
- Was part of the largest pharmaceutical fraud settlements in history
- Has no FDA approval for the conditions it’s used to treat
- Has not been shown to be effective in any double-blind placebo-controlled trials
- May actually prevent the nervous system from repairing itself
What I Recommend Instead
I use many different options for pain management and don’t need to prescribe dangerous drugs like gabapentin. Some of the best options are:
- CBD Oil
- Electroacupuncture (specifically for nerve pain)
- Chinese herbs
- Western herbs
- Homeopathic remedies
Ever since I finished vet school there’s been extraordinary pressure on holistic practitioners. There’s a demand to provide “double-blind, placebo-controlled studies” to prove the modalities work.
Yet Big Pharma can release drugs that are prescribed for off-label use without any studies. Not even safety studies! And for drugs that have severe, sometimes life-threatening side effects.
And, as we saw with gabapentin … when they can’t use them on the human market, they foist them off on veterinarians.
This veterinarian isn’t taking the bait!